OBJECTIVES: While hearing loss is a known late effect of childhood cancer treatment, the impact of childhood cancer treatment on vestibular function has not been comprehensively explored. Vestibular impairment is associated with delayed gross motor development and impaired balance, and thus is important to measure in children. Few studies have examined peripheral vestibular end organ function in this population, and relationships between vestibular and audiometric function in children with cancer are limited. The purpose of this study was to (1) determine if tests of peripheral vestibular function are feasible to administer in children with a diagnosis of cancer; (2) quantify peripheral vestibular function, including assessment of all 10 vestibular end organs, in children with a diagnosis of cancer (cancer group) and age-matched controls (control group), and (3) identify relationships between vestibular and audiometric function. DESIGN: Forty children between the ages of 6 and 17 yr were recruited for the study including 20 children with a diagnosis of cancer and 20 age-matched controls. Function of the vestibular semicircular canals was assessed using horizontal, anterior, and posterior Video Head Impulse testing (vHIT), and function of the vestibular otolith organs was assessed using cervical and ocular vestibular evoked myogenic potential (VEMP) testing. Vestibular loss severity was used to quantify vestibular dysfunction and was compared between groups. Audiometric function was assessed using tympanometry and pure-tone air- and bone-conduction audiograms and was graded according to the SIOP Boston Ototoxicity Scale. RESULTS: vHIT and VEMP testing were feasible to administer in this population. Seventy-five percent of children in the cancer group demonstrated impaired vestibular function in at least one of 10 vestibular end-organ function tests. Children in the cancer group had significantly higher prevalence of vestibular dysfunction on horizontal canal vHIT (p < 0.01) and cVEMP (p = 0.03) testing. Children in the cancer group had significantly greater vestibular loss severity as compared with the control group (p < 0.01). There were no discernable measured relationships between vestibular and audiometric function data. CONCLUSIONS: These findings indicate that comprehensive vestibular function testing should be performed in all children with a diagnosis of cancer, regardless of ototoxic treatment administration and/or presentation of hearing loss. Peripheral vestibular testing was feasible to administer in this population, and helped to identify vestibular dysfunction which may otherwise go undetected.
McCarthy et al. (2026) studied this question.